PREVALENCE OF ORAL MUCOSAL LESIONS IN PEDIATRIC PATIENTS IN KASHMIR VALLEY

1. M.D.S , Dept. of Oral & Maxillofacial Pathology & Microbiology (BBDCODS). 2. M.D.S , Dept. of Pediatric & Preventive Dentistry. 3. M.D. Post graduate Dept. of Anatomy, Govt. Medical College Jammu ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History

Oral mucosal lesions are a broad range of different alterations located in the oral cavity. Most of the studies which describe the prevalence of oral mucosal lesions have been carried out mainly in an adult population. Therefore, in the literature available, there are few reports about oral mucosal lesions and alterations of the normal oral mucosa in pediatric population. A descriptive observational cross-sectional study was conducted, with non-probability sampling for convenience, with a sample of 110 patients and a level of confidence of 95 %. We estimated only 51 children which fitted our inclusive criteria. In 51 patients a prevalence of 37.2 % of oral mucosal lesions was observed. The more prevalent lesions were minor aphthous ulcers (21.5 %), irritation fibroma (15.7 %), traumatic ulcer (15.7 %), traumatic erosion (10.2 %), impetigo (10.2 %), pigmented lesions, recurrent herpes labialis, recurrent intraoral herpes, mucocele, and ranula (5.2 % each). The most frequent location observed in oral mucosal lesions, was labial mucosa (25.0 %), followed by vermilion border (15.0 %), buccal mucosa (15.0 %), labial commissures (10.0 %), buccal groove (5.0 %) etc. in conclusion, even though most of the oral mucosal lesions evaluated in this study can be diagnosed in a purely clinical way; there are some oral mucosal lesions that need confirmation through an anatomo-pathological study.
In kashmir, there are hardly any studies about oral mucosal lesions, neither in adult or pediatric populations. On the other hand, it is important to organize and standardize the criteria of examination for the various medical procedures in oral mucosa.
Several studies in different geographic locations have reported prevalence in oral mucosal lesions. In a study conducted in Argentina by Muniz et al., in 1981, for a total sample of 75 healthy pediatric male patients, ages 6 to 13, 46 patients presented oral mucosal lesions, with a prevalence of 61.3 %. The most common lesions were angular cheilitis (14.7 %), followed by herpes labialis (10.7 %), impetigo (9.3 %), geographic tongue, recurrent aphthous ulcer, and verruca vulgaris (2.7 %) (Muñiz et al., 1981).
In a study carried out in South Africa by Arendorf et al. (1996), with a sample of 1051 patients, a 32.90 % prevalence of oral mucosal lesions was observed. The most prevalent was the recurrent aphthous ulcer (10.87 %), followed by herpes labialis (5.

Material and Method:-
An observational, descriptive study was conducted. Non-probability sampling was used for convenience depending on scheduling and availability of the patients from the Pediatric Dentistry Clinic in kashmir. A sample of 110 patients from a population of 340 patients treated at that clinic in the year 2015, with a 95 % level of confidence, 5 % margin of error, and an estimated of 30 % of the pediatric patients with oral mucosal lesions. The sample was distributed into two groups: healthy patients and patients with systemic diseases.
The inclusion criteria were patients from 3 years old to 13 years old, both genders.
The sample was examined between July and December in 2015. Before this study was carried out on the clinical trial; the patients and their proxies signed an informed consent and assent.
In this study, the instrument used for measuring was the clinical record, based on the clinical exam of the oral mucosa applied by the World Health Organization described in the study "Guide to epidemiology and diagnosis of oral mucosal diseases and conditions" (Espinoza et al.) and in "Pediatric Oral Medicine" a guide of pediatric oral medicine (Witman et al., 2003), where the general data about children was registered by illnesses, type, and location of the lesion. This was carried out through direct observation without using complementary exams, which is why the diagnosis was based on the clinical exam. In case of finding any oral mucosal lesion, a photographic register of the lesion was taken.
The results obtained in the clinical records were processed using Microsoft Office Excel 2011 worksheet, where a descriptive statistic was made, doing statistical process of data.

Results:-
Fifty one pediatric patients were examined in the pediatric dentistry clinic in the Pediatric Dentistry Clinic in kashmir from July to December 2015, where all of the patients studied fitted the inclusion criteria In this group of 51 patients, 24 (47.05 %) were men and 27 (52.9 %) were female. The age group of the patients was from 4 to 13 years of age, with a median of 8, and a mean of 8.7 years old.
Of the entirety of the sample, 19 patients (37.2 %) were diagnosed with at least one oral mucosal lesion during the exam. The frequency percentages of oral mucosal lesion in men and female were 36.2 % in the former and 38.9 % in the latter. Of these, only one patient had two lesions simultaneously (5.2 %).
Respecting the anatomical location of the oral mucosal lesions, 5 were located on labial mucosa, 3 on the vermillion border, 3 on buccal mucosa, 2 on labial commissures, 1 on gingiva, 1 on the floor of the mouth, 1 on the buccal groove, 1 on dorsum of the tongue, 1 on apex of the tongue, 1 attached mucosa, and 1 on the hard palate, (Table II).